Do All Ticks Carry Lyme Disease?

June 16, 2020

Clinical Contributors to this Story

Aryeh Baer, M.D. contributes to topics such as Pediatric Infectious Diseases.

The warm weather is here! Time for fresh air fun with hiking, camping and trips to the beach. But warmer weather also brings some things that are not so welcome: ticks and the germs they spread.

If you find a tick attached to you or to your child, what do you do? Do you need to worry about Lyme disease? Not always, says Aryeh Baer, M.D., a pediatric infectious diseases specialist at Joseph M. Sanzari Children’s Hospital. And even if Lyme disease is a concern, there’s no need to panic, says Dr. Baer. Like so many other infections, Lyme disease is perfectly treatable.

Can any tick bite give me Lyme disease?

No, not all ticks can transmit Lyme disease. In this area, only Ixodes scapularis ticks,also called deer ticks, can spread Lyme disease, and only if the tick is infected with Borrelia burgdorferi, the bacteria that causes Lyme disease. Even after a bite from an infected tick, it must be attached long enough – usually more than 36 hours – to spread the infection to a person.

I just found a tick attached to me. What should I do?

Don’t panic. First, remove the tick with a pair of tweezers. Grasp the tick close to the skin and pull directly upwards until the tick comes free.

Try to remove the tick whole. If you do, it is likely the tick will still be alive and moving. (If the head of the tick separates and stays in your skin, don’t worry. Your body will take care of whatever is left over.)

Place the tick in a plastic bag or other sealed container. Try to identify what kind of tick it is that bit you. An online tick identification chart, like the one from the University of Rhode Island’s TickEncounter Resource Center may be helpful. If you are not sure what type of tick bit you, it is best to bring it to your doctor or someone else who can identify ticks.

It’s important to remember that Lyme disease is not the only infection spread by deer ticks, and deer ticks are not the only ticks that can spread infections. After any tick bite, you should monitor your health. If you develop a high fever or chills, you should seek medical attention, and be sure to mention to the doctor that you have recently had a tick bite.

Should I have the tick tested for Lyme disease?

No, testing a tick for Lyme disease is not helpful. It is usually not the tick you find, but the tick that you don’t find that gives you Lyme. A tick that tests negative for Lyme may only give you false assurance. If you live somewhere with Lyme disease, it is best to assume that the deer tick that bit you is infected and can spread the infection.

Should I be tested for Lyme disease after a tick bite?

Lyme testing relies on detecting antibodies – the body’s reaction to the germ – not the germ itself. It takes time for the body to make antibodies, at least a couple of weeks after you have become infected. Someone with symptoms of very early Lyme disease is likely to have a negative Lyme antibody test. On the other hand, false positive Lyme tests can happen, so someone without symptoms of Lyme disease who tests positive is unlikely to really have the disease. Testing for Lyme disease shortly after a tick bite is not helpful, says Dr. Baer and may lead to a prescription for a medication that you just don’t need.

I found out it was a deer tick that bit me. What should I do now?

If a deer tick bit you, one dose of an antibiotic called doxycycline can prevent Lyme disease if:

  • you live in an area where there is a lot of Lyme disease
  • the tick was probably attached to you for more than 36 hours
  • the tick was removed in the last 3 days

Doxycycline should not be given to pregnant or breastfeeding women or to anyone allergic to doxycycline. If a tick bit you, ask your doctor if you should take doxycycline to prevent Lyme disease.

Is there anything I should look for after a tick bite?

After a tick bite, be on the look-out for signs of infection. The first sign of Lyme disease is usually a gradually enlarging, round or oval red discoloration of the skin surrounding the bite. The rash is usually neither painful nor itchy. Once the infection spreads, the same rash can be seen on other areas of the body. Other symptoms of infection may include:

  • facial droop
  • headache
  • stiff neck
  • slow heart rate
  • fever
  • body aches.

Late manifestations of Lyme include swollen joints, and rarely neurologic problems like severe headaches. Lyme at any stage is treatable with a set course of antibiotics, typically two weeks and rarely more than a month’s duration.

How can I prevent tick bites?

The best way to beat Lyme disease is to avoid the ticks that spread it. Ticks cannot jump or fly, and must wait for a passing animal to grab hold of. They live in areas with tall grass and bushes, and where there are thick layers of plant debris. They do not survive well on well trimmed lawns where the sun will quickly dry them out.

Keep your bushes well trimmed and your lawn free of garden debris. When walking in areas with tall grass or brush, it is important to cover arms and legs with long shirt sleeves and long pants, and to tuck pant cuffs into socks to deny ticks entrance.

Insecticide sprays such as permethrin can be used on clothing before outdoor activities. One application will last in fabric for several months. Insect repellent such as DEET or picaridin can be used on skin, and only last several hours at the most. Apply according to the directions on the package, and be careful not to get it in your eyes or mouth.

After coming in from the outdoors, it is important to look over your body and/or your child’s body for ticks. This is best done in the shower or bath. Pay close attention to areas where the ticks may hide – in the armpits, in the groin, in the belly button, and on the scalp and behind the ears.

Next Steps & Resources

  • Meet our clinical contributor: Aryeh Baer, MD
  • To make an appointment with Dr. Baer or another Hackensack Meridian Health doctor near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.